DOI: http://dx.doi.org/10.18203/2349-3933.ijam20182500

Role of Carica papaya leaf extract tablets/capsules on platelet counts in cases of dengue thrombocytopenia

Venugopal K., Suresh R. M., Halesha B. R.

Abstract


Background: Thrombocytopenia is the hallmark laboratory finding in dengue fever and leads to bleeding manifestations when reduced markedly. So, this causes panic amongst the patient and relatives about the possibility of severity and leading to various complications including bleeding tendencies. Platelet transfusion is the only definitive treatment and it is indicated only in severe cases with bleeding manifestations. Prophylactic platelet transfusion is not much useful unless it’s reduced below 10,000cells/cumm. Carica papaya leaf extract (CPLE) are believed to have some role in improving platelets and its role is unclear. Hence, this study is taken up to evaluate the role of CPLE in improving dengue thrombocytopenia.

Methods: Total 500 patients were included in the study; out of which 380 were males and 120 were females. Patients of dengue fever with thrombocytopenia (Platelet count <1, 50,000 cells/cumm) matching inclusion criteria were included in the study. After the inclusion, patients were randomized into two groups. Study group and control group by simple randomization (even/odd method). The study group treated with CPLE 1100mg three times daily for five days along with symptomatic and supportive treatment. The control group was given only symptomatic and supportive treatment. The average platelet count, average duration of stay and transfusion requirement of platelets were compared using student ‘t’ test.

Results: Increased platelet counts were noted early in the treated group than the controlled group. The average duration of hospital stay was 5.42±0.98 days in study group and 7.2±0.97 days in controlled group. The requirement of platelets is more in control group than study group and it was statistically significant.

Conclusions: Carica papaya leaf extract tablets can be used in patients with dengue thrombocytopenia with clear advantages over control group.


Keywords


Carica papaya leaf extract, Dengue, Platelets, Thrombocytopenia, Thrombocytopenia

Full Text:

PDF

References


Kabra SK, Jain Y, Pandey RM, Singhal T, Tripathi P, Broor S, et al. Dengue haemorrhagic fever in children in the 1996 Delhi epidemic. Trans R Soc Trop Medc Hyg. 1999;93(3):294-8.

WHO (2009) Dengue Guidelines for Diagnosis, Treatment, Prevention and Control WHO (2009) Available at http://whqlibdoc.who.int/publications/2009/9789241547871.

Henchal EA, Putnak JR. The dengue viruses. Clin Microbiol Rev. 1990; 3(4):376-96.

Vaddadi S, Vaddadi RS. Dengue fever: a review article. J Evolut Med Dental Sci. 2015;4(29):5048-8.

Chakravarti A, Kumar A, Malik S. Detection of dengue infection by combining the use of an NS1 antigen based assay with antibody detection. Southeast Asian J Trop Med Public Health. 2011;42(2):297-302.

Mishra B, Sharma M, Pujhari SK, Ratho RK, Gopal DS, Kumar CN, et al. Utility of multiplex reverse transcriptase-polymerase chain reaction for diagnosis and serotypic characterization of dengue and chikungunya viruses in clinical samples. Diagn Microbiol Infect Dis. 2011;71(2):118-25.

Gowda A. A pilot study to evaluate the effectiveness of carica papaya leaf extract in increasing the plate let counts in cases of dengue with thrombocytopenia. Indian Med Gazette. 2015;CXLIX:109-16.

Subenthiran S, Choon TC, Cheong KC, Thayan R, Teck MB, Muniandy PK, et al. Carica papaya leaves juice significantly accelerates the rate of increase in platelet count among patients with dengue fever and dengue haemorrhagic fever. Evidence Based Complement Alternat Med. 2013;2013:616-737.

Siddique O, Sundus A, Ibrahim MF. Effects of papaya leaves on thrombocyte counts in dengue - a case report. J Pakistan Med Ass. 2014;64(3):364-6.

Senthilvel P, Lavanya P, Kumar KM, Swetha R, Anitha P, Bag S, et al. Flavonoid from Carica papaya inhibits NS2B-NS3 protease and prevents Dengue 2 viral assembly. Bioinformation. 2013;9(18):889.